Organization
COUNTRYSIDE DRUG COMPANY II
Active
Organization
COUNTRYSIDE DRUG COMPANY II
Active
Other names
COUNTRYSIDE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN L STRATTON (CFO)
(989) 352-8168
Entity
Organization
Contact information
Practice address
9695 N GREENVILLE RD, LAKEVIEW, MI 48850-9107
(989) 352-8168
(989) 352-6253
Mailing address
9695 N GREENVILLE RD, PO BOX 527, LAKEVIEW, MI 48850-9107
(989) 352-8168
(989) 352-6253
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301004423
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1756241
—
MI
01
—
2039499
PK
—
Enumeration date
11/07/2006
Last updated
10/16/2017
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up